BMJ video: the dangers of overtreatment in the US
False
General clinical
BMJ video: the dangers of overtreatment in the US
Discuss any specialty in this open forum for all healthcare professionals
Yes, it's our own video but other people say they like it too. It's about overtreatment in the US. Overly aggressive treatment is estimated to cause 30 000 deaths among Medicare recipients alone each
0
Cat:OpenClinicalForum:GeneralClinical
Cat:OpenClinicalForum:GeneralClinicalDiscussion:7f222cd0-593d-4fc3-8709-abfb7f4ba97e
Forums » Open clinical » General clinical » BMJ video: the dangers of overtreatment in the US
|
BMJ video: the dangers of overtreatment in the US
posted at 5/10/2012 12:45 PM BST
on bmj.com
|
|
*Moderator*
Posts: 696
First: 17/11/2008 Last: 19/6/2013 |
Yes, it's our own video but other people say they like it too. It's about overtreatment in the US. Overly aggressive treatment is estimated to cause 30 000 deaths among Medicare recipients alone each year. Overall, unnecessary interventions are estimated to account for 10-30% of spending on healthcare in the US, or $250bn-800bn (£154bn-490bn; €190bn-610bn) annually. Watch it and weep. or just watch it. |
|
|
Re: We think this is great
posted at 5/10/2012 1:24 PM BST
on bmj.com
|
|
*Moderator*
Posts: 1497
First: 7/4/2011 Last: 19/6/2013 |
In Response to We think this is great: Yes, it's our own video but other people say they like it too. It's about overtreatment in the US. Overly aggressive treatment is estimated to cause 30 000 deaths among Medicare recipients alone each year. Overall, unnecessary interventions are estimated to account for 10-30% of spending on healthcare in the US, or $250bn-800bn (£154bn-490bn; €190bn-610bn) annually. Watch it and weep. or just watch it. http://www.youtube.com/watch?v=uJ6NufAb2qc&feature=plcp Posted by luisad The graph at the beginning is very stark. In theory, when a country spends more on healthcare it should be healthier. The USA seems to spend a lot more than other OECD countries but its life expectancy is 78 years old, which is lower than other countries. (Although 78 years is still pretty good) The video explains that a culture of screening and testing dresses itself up as helpful but actually leads to many more unncessary interventions. The story about the colloid cyst on the young guy's brain was a case in point. His primary care physician said to leave it and monitor it for a year or so because it was not likely to cause any problems, however, the patient's neurosurgeon overruled this and said that he needed an emergency operation to remove it. What follows was a complete disaster: the patient was paralysed as a result and died not soon after. What struck me was the information available to physicians in the US. 80% of clinical trial data is done by pharma who have their own interests in terms of what trials they undertake and indeed what they choose to publish. It seems that there isn't an evidence-base for many interventions but doctors are incentivised to do more because they will get paid more. It seems if the US public and physicians want more evidence-based data on interventions, treatments etc, they are going to have to invest in it, which will mean taxes. |
|
|
Re: We think this is great
posted at 5/10/2012 1:38 PM BST
on bmj.com
|
Posts: 2139
First: 12/3/2010 Last: 19/6/2013 |
Very much about America, but that is no criticism. Ideal for the new BMJ-US! I'd like to see a similar investigation about the UK. I'm often seeing patients in my Anaesthesia Clinic with benign conditions who have co-morbidity that will make their surgery much more risky. Sure, I'm seeing them, counselling them and letting them make the decision, and my surgeons are referring them to me so I can do that, but I sometimes think there isn't enough time in a surgical OPD to have that sort of conversation, so it's left to the anaesthetist. John |
|
|
Re: We think this is great
posted at 5/10/2012 3:17 PM BST
on bmj.com
|
Posts: 233
First: 15/5/2012 Last: 11/6/2013 |
You have to put this in prespective. We, in the US have different constraints. Part of the "overtreatment" and so called practice of defensive medicine is because of the spectre of being sued should an unfortunate event happen. I think the prevelant thought process is that it is better safe than sorry. |
|
|
Re: We think this is great
posted at 5/10/2012 3:42 PM BST
on bmj.com
|
Posts: 1343
First: 13/4/2010 Last: 19/6/2013 |
The problem is that if "better safe than sorry" leads to over-investigation and over-treatment then it's not safe. Believe me this is not a problem unique to the US (although I do think your system of income capture and income generation magnifies it). |
|
|
Re: We think this is great
posted at 5/10/2012 4:31 PM BST
on bmj.com
|
Posts: 1302
First: 9/12/2011 Last: 12/6/2013 |
Happy is right, In the USA if a Neurosurgeon elects not to operate, and the patient dies from a Malignant aggressive Tumor then there is aggressive Legal action in many cases, Doctors are hesitant, Dare I say Scared to treat conservatively. Even in an Urgent care setting, a child with a Bronchitis infection who is going to be given antibiotics will be givena strep test, when no evidence of Strep throat is present, and in alot of cases the antibiotic given will eliminate Strep anyway.. I guess you could say US Medicine is more aggressive, although not neessarily to the best outcomes always. DuaneF |
|
|
Re: We think this is great
posted at 5/10/2012 10:37 PM BST
on bmj.com
|
Posts: 3059
First: 27/3/2012 Last: 13/6/2013 |
The picture depicted in the video applies to nearly all countries. It is very sad to say that financial incentives in a bad combination of local politics & commercial interests of pharmaceutical industries does harm the innocent population. |
|
|
Re: We think this is great
posted at 9/10/2012 3:42 PM BST
on bmj.com
|
|
*Moderator*
Posts: 1497
First: 7/4/2011 Last: 19/6/2013 |
In Response to Re: We think this is great: You have to put this in prespective. We, in the US have different constraints. Part of the "overtreatment" and so called practice of defensive medicine is because of the spectre of being sued should an unfortunate event happen. I think the prevelant thought process is that it is better safe than sorry. Posted by Happy Thanks to both Happy and Duane for the US input. Defensive medicine is an interesting point and the fear of being sued if you miss something must prey on the minds of US doctors. However, is this also a symptom of market based healthcare systems, by where the patient is the customer and is paying for the doctor to make the right decision, so if that service or advice is wrong, then they have more in the way of 'consumer rights'? Don't get me wrong, I am sure that patients in the UK might sue doctors/hospitals if they miss something, but perhaps the fear of being sued is stronger over in the US so as you say, its better to be safe than sorry. I would interested to hear kirked's medicolegal point of view on this.... |
Forums » Open clinical » General clinical » BMJ video: the dangers of overtreatment in the US
